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NPI Code Detail

MEDICARE: CENTRAL MEDICAL SPECIALISTS LLC

MEDICARE: CENTRAL MEDICAL SPECIALISTS LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261QA1903XAmbulatory Surgical Clinic/Center
2111N00000XChiropractorIL
3213E00000XPodiatristIL
4225100000XPhysical TherapistIL
5208VP0014XInterventional Pain Medicine PhysicianIL
6207X00000XOrthopaedic Surgery PhysicianIL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
11601972OTHERILBLUE CROSS BLUE SHIELD OF ILLINOIS

General Provider Information

NPI Number : 1104066398
Entity Type Code : Organization
Provider Name (Legal Business Name) : CENTRAL MEDICAL SPECIALISTS LLC
Provider Business Mailing Address
First Line : 2715 N CENTRAL AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60639-1351
Country : US
Telephone Number : 312-326-6100
Fax Number : 773-385-6890
Provider Business Practice Location Address
First Line : 2715 N CENTRAL AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60639-1351
Country : US
Telephone Number : 312-326-6100
Fax Number : 773-385-6890
Authorized Official
Title or Position : MANAGING PARTNER
Name : DR. JOHN J OKEEFE
Credential : M.D.
Telephone Number : 312-326-6100
Provider Enumeration Date : 02/27/2009
Last Update Date : 09/28/2012

Similar Medicare Providers

1750633061 — CENTRAL MEDICAL SPECIALISTS, LLC
Practice Location Address:
2715 N CENTRAL AVE
CHICAGO, IL
60639-1351
Practice Phone: 312-326-6100
Practice Fax: 773-385-6890
1558704577 — JAY SWEIS D.D.S P.C
Practice Location Address:
2715 N CENTRAL AVE , SUITE A
CHICAGO, IL
60639-1351
Practice Phone: 773-308-5542
Practice Fax:
1275936486 — DR. WARREN BRADEN SR. ED.D.
Practice Location Address:
2715 N CENTRAL AVE
CHICAGO, IL
60639-1351
Practice Phone: 773-360-1389
Practice Fax: 773-687-9412
1992256218 — CAROLINA THERAPEUTIC SERVICES, INC
Practice Location Address:
2715 N CENTRAL AVE
CHICAGO, IL
60639-1351
Practice Phone: 773-360-1389
Practice Fax: 773-687-9412
1356959332 — NIKHITA MOOLAYIL
Practice Location Address:
2715 N CENTRAL AVE
CHICAGO, IL
60639-1351
Practice Phone: 773-360-1389
Practice Fax:
1124766266 — MS. LORIE ESTHER FUENTES
Practice Location Address:
2715 N CENTRAL AVE
CHICAGO, IL
60639-1351
Practice Phone: 773-360-1389
Practice Fax: 773-687-9412

Directions to “CENTRAL MEDICAL SPECIALISTS LLC ” Practice Location

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